Good news -- widespread denunciation of the euthanasia/"death panel" myth as false by the press is prompting conservative elites to distance themselves from the claim.

National Review is calling Sarah Palin's "death panel" rhetoric "hysteria." Senator Chuck Grassley quietly retracted his claim that the government could decide to "pull the plug on grandma" under proposed health care legislation in Congress. And even more extreme sources like Fox News, Glenn Beck, and Dick Morris have been forced to concede that there is no explicit "death panel" provision in the legislation (though they argue that it will create rationing that amounts to "de facto death panels").

This trend gives me hope that the elite-focused naming and shaming strategy that I've advocated (here and here) can work.

Unfortunately, myths spread so quickly these days that the damage to the health care debate may already be irreversible. A Pew poll released yesterday finds that 86% of Americans have heard of the "death panel" claim. Among this group, fully half of Americans either believe the claim is true (30%) or don't know (20%), including 70% of Republicans (47% true, 23% don't know). Results from a Daily Kos/Research 2000 poll using different wording are nearly as discouraging -- they estimate that 11% of Americans and 28% of Republicans think "death panels" are real, and an additional 17% of Americans and 31% of Republicans aren't sure. Either way, it's not clear that subtle backtracking by conservative elites will move those numbers back down anytime soon.

Update 8/24 10:25 AM: The Washington Post's Charles Krauthammer also admitted that "there are no 'death panels' in the Democratic health-care bills, and to say that there are is to debase the debate." However, like Fox, Beck, and Morris, he then goes on to claim that the funding of end of life consultations is "intended to gently point the patient in a certain direction, toward the corner of the sickroom where stands a ghostly figure, scythe in hand, offering release."

Emily Swanson |
August 21, 2009

Recently, there has been a lot in the news about the health insurance reforms being proposed by President Barack Obama. I am going to read a list of statements about his proposed health insurance reform plan. After each statement, please tell me whether or not you believe it is true.

If the reforms pass, the Federal Government will become directly involved in making personal health care decisions for you.

53% Yes, 47% No

If the reforms pass, health care services such as treatments, physicians, and care will be rationed.

54% Yes, 46% No

If the reforms pass, a public insurance option will put private insurance companies out of business.

36% Yes, 64% No

If the reforms pass, the Federal Government will make decisions about whether you will be treated or not.

49% Yes, 51% No

If the reforms pass, all illegal immigrants will be covered.

46% Yes, 54% No

If the reforms pass, the government will require the elderly to make decisions about how and when they will die.

31% Yes, 69% No

If the reforms pass, they will cover more Americans by making cuts to Medicare.

Emily Swanson |
August 21, 2009

In any health care proposal, how important do you feel it is to give people a choice of both a public plan administered by the federal government and a private plan for their health insurance

77% Very/Quite important
22% Not that/Not at all important

Please tell me which ONE statement you agree with more on the issue of creating a new public health plan administered by the federal government. Some people say it would help lower health care costs because it would compete with private health plans. This new public plan would provide coverage for the uninsured and all Americans would have an option for quality affordable health care. Other people say that patients might not always have access to their choice of doctors and the government would lower costs by limiting medical treatment options and decisions that should be made instead by patients and doctors.

42% Provide care for all
46% Limit access to doctors

Now I am going to tell you more about the health care plan that President Obama supports and please tell me whether you would favor or oppose it. The plan requires that health insurance companies cover people with pre-existing medical conditions. It also requires all but the smallest employers to provide health coverage for their employees, or pay a percentage of their payroll to help fund coverage for the uninsured. Families and individuals with lower- and middle-incomes would receive tax credits to help them afford insurance coverage. Some of the funding for this plan would come from raising taxes on wealthier Americans. Do you favor or oppose this plan?

Overall, given what you know about them, would you say you support or oppose the
proposed changes to the health care system being developed by (Congress) and (the
Obama administration)? Do you feel that way strongly or somewhat?
45% Support, 50% Oppose (chart)

Do you think Obama will or will not be able to make significant improvements in
this country's health care system?
49% Will, 46% Will not

Would you support or oppose having the government create a new health insurance
plan to compete with private health insurance plans? Do you feel that way strongly or
somewhat?
52% Support, 46% Oppose

In my earlier post (Part I) on this subject, I suggested it would be a political miracle if Democrats did not lose U.S. House seats in the 2010 election. A major reason is that in mid-term elections, the voters most likely to turn out are those who are disgruntled with the policies of the incumbent president, rather than his supporters. In fact, since Democrats and Republicans first began competing against each other for Congress in the mid-19th Century, the president's party has lost seats in mid-term elections, relative to the "out" party, all but three times - 1934, 1998 and 2002.

The two most recent times seem to be special situations that are likely to have little relevance for 2010. The 2002 mid-term election saw the president's party pick up a few seats, probably because the country was still rallying around the flag in reaction to the terrorist attacks the previous year. President Bush's approval rating was still high (Gallup showed it at 68 percent in a poll conducted Nov. 8-10, 2002).

And the 1998 mid-term election found voters quite dissatisfied with the Republicans' vote to impeach President Clinton, apparently a major reason why the president's party was able to pick up a few House seats. In both years, the Republicans enjoyed slim majorities, and the changes did not affect their majority control.

If neither of the two exceptions just noted appear to have much relevance to what might happen in 2010, the third exception (the first chronologically) is a different story. Taking place just two years after President Roosevelt came into office during the Great Depression, the 1934 mid-term election campaign focused largely on the New Deal measures adopted by Congress. The result was a net increase of 9 seats for the president's party - from 313 to 322. Democrats today no doubt hope that a similar debate about the economic stimulus bills and health care reform will be a positive inducement for voters next year.

That's where the differing poll results - depending on whether the pollsters use "likely voters" or not - provide an interesting story. The latest results (noted in my previous article) suggest the Democrats have an overall lead in the congressional house vote of from six to seven percentage points among the general public or registered voters, but are apparently in a dead heat with Republicans based on likely voters.

If indeed, the two-party aggregate vote is about even on Election Day, that would almost certainly result in major seat losses for the Democrats, though it's difficult to say how many. The aggregate two party vote (the total voting for Democrats vs. Republicans in the country as a whole) is not a perfect indicator of how well the parties fare in winning House seats. In 2002, for example, the Republicans won 54.1 percent of the two-party vote nationwide, but got 52.6 percent of the House seats. In 2004, they won a smaller percent of the two-party vote (51.4 percent) but picked up three seats, expanding their majority to 53.3 percent of the seats.

In 2006, the Democrats won 54.2 percent of the aggregate vote, and won about the same percentage of House seats - 53.6 percent. Two years later, their share of the national vote increased by only .4 percent (to 54.6 percent), but they gained 21 seats to hold 59.0 percent of the House seats.

Despite the inconsistency between the percentage of the national vote and the percentage of House seats won by the majority party, a tie vote nationally would likely cause the Democrats to lose a significant number of seats. The Democrats beat the Republicans in 2006 and 2008 by about 8 to 9 percentage points. Currently, not many polls suggest the Democrats will win by that margin in 2010.

Of course, with more than a year to go, much can happen to shape the political landscape. No doubt, the most salient domestic issues will be the stimulus bills and health care reform, and no one knows for sure what will happen to the latter. And then there is always the possibility of some major international event that could influence the elections.

Democrats may hope for a repeat of the 1934 mid-term election, but history tells us the circumstances will have to be quite unusual for that to happen. As indicated in Part I, given the expected low turnout, I'd be especially attentive to the preferences of "likely voters." If they indicate a Democratic lead of 8 to 10 points, that would be unusual indeed.

Emily Swanson |
August 20, 2009

Do you think _______ would be better off or worse off if the president and Congress passed health care reform, or don't you think it would make much difference?

You and your family:
36% Better off
31% Worse off
27% Not much difference

The country as a whole:
45% Better off
34% Worse off
14% Not much difference

The Medicare program for seniors:
38% Better off
30% Worse off
19% Not much difference

And if the president and Congress do pass health care reform, do you think the nation would end up spending more on health care, less on health care, or would it stay about the same?
61% More
16% Less
17% Same

Do you favor or oppose creating a government-administered public health insurance option similar to Medicare to compete with private health insurance plans?
59% Favor
38% Oppose

Emily Swanson |
August 20, 2009

Do you approve or disapprove of the way Obama is handling the situation in Afghanistan?
60% Approve
33% Disapprove

All in all, considering the costs to the United States versus the benefits to the United States, do you think the war in Afghanistan was worth fighting, or not?
47% Worth fighting
51% Not worth fighting

Do you think the number of U.S. military forces in Afghanistan should be increased, decreased, or kept about the same?
24% Increased
45% Decreased
27% Kept about the same

All told, do you think the United States is winning or losing the war in Afghanistan?
42% Winning
36% Losing

As you may know Afghanistan is holding national elections [next/this] week,how confident are you that these elections will produce a government that can rule the country effectively?
34% Confident
64% Not confident

Emily Swanson |
August 19, 2009

Suppose the President and Congressional Democrats decide not to include the public option in the final health care legislation. Would that make the legislation better, worse, or have no impact?
22% Better, 41% Worse

Think about the health care reform legislation currently being considered in Congress and suppose that the public option is dropped from the plan. Would you strongly support, somewhat support, somewhat oppose, or strongly oppose the Congressional health care reform bill without a public option?
34% Support, 57% Oppose

In a recent article by F. Annie Pettit in the MRA's Alert! Magazine (http://www.mra-net.org/alert/), the author discusses Twitter and potential market research applications. The article (titled "Can Marketing Research Really be Conducted Using Twitter?") is worth reading for several reasons.

First, social media and the digital explosion is an undeniable trend, and it can be harnessed for qualitative (not quantitative) research purposes. Twitter could clearly be used as a part of a qualitative feedback loop for corporations or institutions with a desire to constantly track customer perception and experience. In the marketing and research industries these systems are often referred to as EFM or "enterprise feedback management". Twitter/Tweet monitoring and tracking could make a useful complement to the hosted online communities that many consumer brand companies are building. Communispace (http://www.communispace.com/) and VoVici (http://www.vovici.com/) are two hosted online community providers that leap immediately to mind. If they aren't already, I would expect these two firms to develop social media conversation monitoring as a tandem product.

Second, the author clearly notes that (a) it is impossible to make Twitter data nationally projectable and (b) it is unlikely that it could ever become a quantitative tool. She clearly notes that, "a major drawback reflects the lack of a quality sampling method, a core requirement for obtaining valid and reliable research results." Inevitably, there will be companies over the next few years that will claim to have a conversation analytics offering built upon a social media application that is a statistically projectable quantitative tool. This will annoy real researchers immeasurably.

Third, Pettit notes that on larger subjects or widely used products, an enormous amount of qualitative data could be mined. With advances in text analytics software, research and marketing teams could identify fast moving trends by looking for words or phrases that pop overnight. For example, a travel destination like Dubai could track tweets that utilize standard travel terms and Dubai. A daily or weekly sampling of this datastream could then focus on aspects of the consumer experience and look for patterns, problems and opportunities. Large CPG companies and service-based companies (airlines, amusement parks, etc.) could find this analysis useful.

Finally, monitoring and analyzing conversation streams like Twitter is a passive, non-interventional type of qualitative research. Recently referred to as "listening outposts" in the market research community (see Surinder Siama's April, 2009 article in Research World), there is something to be said for the purity and authenticity of this type of unprompted qualitative data.

This is just the beginning of a much larger trend in market research. Watch for it.

During these August weeks when Washington has all but shut down, I thought this would be a good opportunity to do a brief run-down of polls in my beloved home state of Florida. (I was born and raised in Orlando and keep a close eye on how things are evolving back home.)

SENATE:

In the GOP Primary, Crist has maintained over 50% in the ballot test against Rubio, who started with little name ID and has risen to the the mid-20's.

The story here is not particularly surprising: Rubio's numbers began low and had nowhere else to go but up. The race also does not appear to be shifting dramatically or wildly; rather we see the slow and steady increase of Rubio's numbers as more people learn who he is. For example, the Quinnipiac poll released today has the race at 55-26, a very modest gain for Rubio over its 54-23 finding from June.

Buried within the numbers that have come out over the last few months is both good and bad news for Crist. On the upside for Crist, his job approval is good: 60% is a pretty strong number for a Governor in a state that is going through a rough time that is actually shrinking in population for the first time in recent memory. Crist is also not a polarizing figure and general election opponents should be very afraid: Crist's job approval among Democrats is 54%.

Yet there are weaknesses Crist will have to address: namely, the way the ballot test looks when name ID isn't an issue, and the way GOP primary voters stand on items like the stimulus. A poll conducted for Club for Growth in June showed 75% of FL GOP primary voters say the "stimulus was bad" - given Crist's support for the stimulus, this presents a major weakness. Furthermore, a June poll conducted by Mason Dixon showed that among Republicans who know of both Crist and Rubio, the race tightens significantly and Rubio pulls near even. Crist has held onto his share on the ballot test overall but as more Floridians hear Rubio's message, Crist's numbers are vulnerable.

On the Democratic side, the primary is crowded and the candidate who performs the best on the ballot test is Kendrick Meek who still comes in around the teens and 20's.

Because the Democratic field is full of a variety of candidates with regional or district-based appeal but without large statewide name ID, a ballot test is difficult at this point in the game and perhaps not highly illuminating. Nonetheless, the polls show Crist with a large margin over current Democratic frontrunner in the polls Kendrick Meek.

GOVERNOR

While much of the discussion around the Senate race focuses on the primaries, the Governor's race looks like it will likely come down to Attorney General Bill McCollum and state CFO Alex Sink. The aforementioned Quinnipiac poll out today shows McCollum leading the race 38-34 among registered voters, with a 38-23 advantage among independent voters. This is similar to a Mason-Dixon poll from June that showed McCollum with a 41-27 advantage among independents.

While these numbers - and in particular, the advantage among independents - must be seen as reassuring news for Team McCollum, voters don't have an enthusiastically favorable view of either candidate. In that June Mason-Dixon poll, McCollum's name ID was 87% - unsurprising given his long electoral career in the state - but his favorables were only at 29%, with 45% saying they are "neutral". Today's Quinnipiac poll shows better numbers for McCollum, with 42% favorable and 13% unfavorable.

NBC released a health care poll (PDF) last night that deputy political director Mark Murray summarized in an article with the subhed "Misperceptions abound on president's health overhaul initiative":

Majorities in the poll believe the plans would give health insurance coverage to illegal immigrants; would lead to a government takeover of the health system; and would use taxpayer dollars to pay for women to have abortions -- all claims that nonpartisan fact-checkers say are untrue about the legislation that has emerged so far from Congress.

Forty-five percent think the reform proposals would allow the government to make decisions about when to stop providing medical care for the elderly.

That also is untrue: The provision in the House legislation that critics have seized on -- raising the specter of "death panels" or euthanasia -- would simply allow Medicare to pay doctors for end-of-life counseling, if the patient wishes.

While it's great to see major news organizations polling on misperceptions, the wording of the NBC poll questions means that we can't draw sharp conclusions about the extent to which the public has mistaken beliefs about the actual contents of the legislation before Congress.

The problem is that NBC asked respondents if various results were "likely to happen" under the proposed health care plan, a vague phrase that allows for implausible but increasingly popular fallback position that the provisions in question are not in the plan but will somehow result from it in practice. (See, for instance, Rudy Giuliani's defense of the "death panels" myth.) It would have been preferable to first ask respondents what provisions they thought were part of the legislation and then to ask if they think "death panels" and other doomsday scenarios would be the eventual result.

An update on state polling on the Obama birth certificate myth -- Public Policy Polling has released a preview of a new poll showing that 43% of Colorado Republicans think President Obama was not born in this country and an additional 24% were unsure. Those numbers are comparable to the numbers that PPP found in Virginia (41% no, 27% not sure) and North Carolina (47% no, 29% not sure) and much worse than those found in Utah (13% no in a poll conducted by local media), suggesting that birther-ism may be prevalent among Republicans in states outside of the South that lack large black populations.

It would be a political miracle if the Democrats did not lose seats in the 2010 Congressional elections, yet the polls so far suggest that scenario is doubtful at best. I think it's because most polls are providing a rosier picture for the Democrats by reporting voting intentions of the general public, or registered voters, rather than the much smaller segment of "likely voters" that will ultimately turn out to cast a ballot.

That the Democrats will almost certainly lose House seats in 2010 is attested to by several factors. The most important, of course, is that since the advent of the current two party system (Republicans and Democrats), the party of the president almost always loses seats in a mid-term election. The best theory for this phenomenon is that disgruntled people (i.e., those who identify with the "out" party) are more motivated to cast a protest vote than the relatively satisfied people (i.e., those who identify with the party of the president) are to cast a vote of support.

The second factor is that, in the wake of the protracted war in Iraq and the sagging economy, Democrats won many seats in 2006 and 2008 that would "normally" go to Republicans. In 2010, with Bush gone and a Democratic administration in charge, Democratic House members in those "normally" Republican seats are going to be quite vulnerable.

The final factor is that as a general rule, Republicans are more likely to turn out than Democrats, because Republicans tend to be higher on the socio-economic scale - generally more educated, with higher incomes, and more actively involved in politics than Democrats.

So, if all of these reinforcing factors suggest the Republicans are likely to gain seats, why aren't the polls showing that? Here are some interesting recent poll results (see pollingreport.com):

July-August Polls 2009 Measuring Support

for Congressional Candidates, 2010

Date

Poll

Democrats

Republicans

Unsure/neither/dk

Democratic
advantage

%

%

%

Pct Pnts

Aug 10-13

(general public)

Daily Kos/

Research 2000

36

28

36

+8

July 31-Aug 1

(general public)

CNN/Opinion Research Corp

44

34

22

+10

July 24-27

(general public)

NBC/Wall Street Journal

46

39

15

+7

July
22-26

(likely
voters)

NPR/POS
and GQRR

42

43

15

-1

July
19-23

(likely
voters)

GWU
- Tarrance/Lake

43

40

17

+3

July 9-13

(registered voters)

Diageo/Hotline

39

32

30

+7

July 10-12

(registered voters)

Gallup

50

44

7

+6

Note that there is little difference in the lead that polls show for Democrats when the sample is either the general public or registered voters - from six to ten percentage points. However, the two polls that reported results based on "likely voters" show essentially a dead heat (a 3-point Democratic lead or a one-point Republican lead).

Nate Silver (at fivethirtyeight.com) suggests caution in relying on likely voter models this early in the 2010 campaign. Generally, I agree that early polls - especially in specific races (as opposed to the more general generic ballots reported above) - need to be viewed with caution. Many people are undecided 10 to 12 months ahead of the election, though some pollsters obscure that fact by using a forced choice format. See, for example, the contrast between Diageo/Hotline and Gallup above, the former showing 30 percent of registered voters undecided, Gallup showing just 7 percent.

Furthermore, different polling organizations use different screeners to arrive at their presumed "likely voters," some more "aggressive" than others. So, it's difficult to make direct comparisons with polls showing different leads, even if they base their results on likely voters, rather than registered voters or the general public.

That said, I would argue that in general we get a more realistic view of the general sentiment of voters, if the sample has been screened fairly tightly to produce a relatively small segment of likely voters rather than a much larger group of people - the general public or even "registered voters." In mid-term elections, turnout is only about half or so of turnout in presidential elections. Thus, screening out the non-voters is much more sensitive for understanding mid-term elections than presidential elections.

So, contrary to Nate Silver's advice, I would suggest that when polls diverge, one based on likely voters is probably a better reflection of the actual electorate than a poll based on the general population or even registered voters.

(In Part II I will discuss the exceptions to the general rule that the president's party loses House seats in mid-term elections, and whether those exceptions are relevant to 2010.)

Emily Swanson |
August 18, 2009

Since the RWJF Index was introduced in the spring of 2009, seniors who are eligible for Medicare have reported the highest confidence levels. While this group again reported the highest confidence level in July (106.8), their confidence dropped 10.4 points since the previous month. Individuals age 50-64 have consistently had the lowest confidence levels since the survey began. Last month, the confidence level for that group fell just 4.4 points from 95.1 points in June to 90.7 in July.

"Over the past few months, Americans have been increasingly bombarded with conflicting information about their health care, and some of it has probably been misinformation about health reform," said Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of the Robert Wood Johnson Foundation. "It is no surprise that consumer confidence in health care is erratic right now. People are confused about all of the different information they are hearing and not sure whom to trust."

In a follow-up question explaining the benefits and disadvantages associated with a public plan, 45% said they agreed with the description -- by supporters -- that it would help lower health-care costs and provide coverage for uninsured Americans.

But 48% sided with opponents who say a public option would reduce access to their choice of doctors, and would lower costs by limiting medical treatment options.

Emily Swanson |
August 18, 2009

Do you think the health care reform plan being considered by President Obama and Congress creates "death panels" which have the authority to subjectively determine whether or not a gravely ill or injured person should receive health care based on their "level of productivity in society"?

11% Yes
72% No

Does the health care reform plan being considered by President Obama and Congress require elderly patients to meet with government officials to discuss "end of life" options including euthanasia?

19% Yes
58% No

Which of the following do you consider to be the most accurate reflection of the health care reform plan being considered by President Obama and Congress?

26% A government take over the entire health care system
47% The government will provide a non-profit health insurance option to compete with private firms